1
|
Nickel B, Heiss R, Shih P, Gram EG, Copp T, Taba M, Moynihan R, Zadro J. Social Media Promotion of Health Tests With Potential for Overdiagnosis or Overuse: Protocol for a Content Analysis. JMIR Res Protoc 2024; 13:e56899. [PMID: 38833693 PMCID: PMC11185923 DOI: 10.2196/56899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/19/2024] [Accepted: 05/02/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND In recent years, social media have emerged as important spaces for commercial marketing of health tests, which can be used for the screening and diagnosis of otherwise generally healthy people. However, little is known about how health tests are promoted on social media, whether the information provided is accurate and balanced, and if there is transparency around conflicts of interest. OBJECTIVE This study aims to understand and quantify how social media is being used to discuss or promote health tests with the potential for overdiagnosis or overuse to generally healthy people. METHODS Content analysis of social media posts on the anti-Mullerian hormone test, whole-body magnetic resonance imaging scan, multicancer early detection, testosterone test, and gut microbe test from influential international social media accounts on Instagram and TikTok. The 5 tests have been identified as having the following criteria: (1) there are evidence-based concerns about overdiagnosis or overuse, (2) there is evidence or concerns that the results of tests do not lead to improved health outcomes for generally healthy people and may cause harm or waste, and (3) the tests are being promoted on social media to generally healthy people. English language text-only posts, images, infographics, articles, recorded videos including reels, and audio-only posts are included. Posts from accounts with <1000 followers as well as stories, live videos, and non-English posts are excluded. Using keywords related to the test, the top posts were searched and screened until there were 100 eligible posts from each platform for each test (total of 1000 posts). Data from the caption, video, and on-screen text are being summarized and extracted into a Microsoft Excel (Microsoft Corporation) spreadsheet and included in the analysis. The analysis will take a combined inductive approach when generating key themes and a deductive approach using a prespecified framework. Quantitative data will be analyzed in Stata SE (version 18.0; Stata Corp). RESULTS Data on Instagram and TikTok have been searched and screened. Analysis has now commenced. The findings will be disseminated via publications in peer-reviewed international medical journals and will also be presented at national and international conferences in late 2024 and 2025. CONCLUSIONS This study will contribute to the limited evidence base on the nature of the relationship between social media and the problems of overdiagnosis and overuse of health care services. This understanding is essential to develop strategies to mitigate potential harm and plan solutions, with the aim of helping to protect members of the public from being marketed low-value tests, becoming patients unnecessarily, and taking resources away from genuine needs within the health system. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56899.
Collapse
Affiliation(s)
- Brooke Nickel
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Raffael Heiss
- Center for Social & Health Innovation, Management Centre Innsbruk, Innsbruk, Austria
| | - Patti Shih
- Australian Centre for Health Engagement Evidence and Values, School of Health and Society, University of Wollongong, Wollongong, Australia
| | - Emma Grundtvig Gram
- Center for General Practice, Department of Public Health, University of Copenhagen, Denmark, Australia
| | - Tessa Copp
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melody Taba
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ray Moynihan
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Joshua Zadro
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
2
|
McCartney M, McCutcheon C, Cooke M, MacDonald R, Mekwi L, Noruddin UH, O'Keeffe M. Investigation into financial conflicts of interest and screening for atrial fibrillation in the UK: a cross-sectional study. BMJ Evid Based Med 2023; 28:15-20. [PMID: 36216511 DOI: 10.1136/bmjebm-2022-112004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To understand the relationship between financial conflicts of interest and recommendations for atrial fibrillation (AF) screening in the UK, via examining (1) if the UK media recommend for or against screening for AF, and (2) the financial conflicts of interests of AF screening commentators. DESIGN Cross-sectional study. SETTING/PARTICIPANTS References in UK mainstream media, Twitter, the UK's National Health Service (NHS), patient information websites and major UK heart-related charities regarding screening for AF between1 January 2018 and 31 July 2021. OUTCOME MEASURES Proportion of references advocating for, against and presenting balanced/neutral views on screening. Proportion of references citing commentators with financial conflicts of interest. RESULTS 217 media stories were identified, containing 284 comments about screening for AF. 185/217 (85.3%) of articles were in favour, 9 (4.1%) were against and 23 (10.6%) were balanced. Quotations within were located from 194 commentators; 44 were quoted more than once. 41/44 (93.2%) were in favour of screening. Of these 41, 37 (90.2%) had a direct or indirect financial conflict of interest, including that due to a work role. Two were balanced and one was negative. 2553 tweets using 3 hashtags promoting screening were analysed. 2119 (83%) of the most impactful tweets promoting AF screening were by industry or organisations with industry funding. Of 23 NHS organisations holding information about funding and promoting AF screening online, 22 (96%) had industry funding. 9 (90%) of the top 10 patient information websites promoting AF screening had industry funding. Four main UK patient charities in this sector promoting screening received industry funding. CONCLUSIONS The vast majority of UK media promotes screening for AF, in contrast to the position of the independent UK National Screening Committee, which recommends against screening. Most commentators, internal NHS organisations and UK charities promoting screening had a direct or indirect financial conflict of interest. Independent information was rare. The reasons for this are unknown. Readers should consider the potential for the impact of financial conflicts on recommendations to screen.
Collapse
Affiliation(s)
| | | | | | | | - Lena Mekwi
- Medical School, University of Glasgow, Glasgow, UK
| | | | - Mary O'Keeffe
- Institute for Musculoskeletal Health, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
3
|
Xu C, Luo L, Zeng S, He X, Li J, Zhu G. What Promotes Medical Overuse: Perspective on Evolutionary Game between Administration and Medical Institutions. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4351282. [PMID: 36158130 PMCID: PMC9492337 DOI: 10.1155/2022/4351282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/28/2022] [Indexed: 11/17/2022]
Abstract
Medical overuse is the leading cause of high expenditure among healthcare systems worldwide, with the degree varying from region to region. There is increasing evidence to indicate that in China, National Healthcare Security Administration (NHSA) supervision plays the most crucial role in decreasing medical overuse. For medical overuse, traditional studies focus on empirical researches and qualitative analysis, most of which ignore how the two important participants, i.e., medical institutions and NHSA, affect the strategy of each other. To reduce the losses incurred by insufficient supervision, this study starts from bounded rationality, builds an evolutionary game model to study the relations between the NHSA and medical institutions, and reveals the dynamic evolution process of the supervision of NHSA and overuse of medical institutions. Through stable evolutionary strategy analysis, numerical simulation results, and sensitive experiments under diverse scenarios, we found that when profit gap of medical overuse is high or low, medical institution will adopt fixed strategy, which is medical overuse or appropriate medical use. Only when the profit gap is at a medium level will NHSA's choice affects medical institutions' strategy. Furthermore, NHSA's strategy is affected by the profit gap between medical use and supervision cost. Our work enriches the understanding of supervision for medical overuse and provides theoretical support for the NHSA to make decisions to reach an ideal condition, i.e., to supervise without exertion.
Collapse
Affiliation(s)
- Chenxi Xu
- Business School, Sichuan University, No. 24 South Section 1, Yihuan Road, Chengdu, China
| | - Li Luo
- Business School, Sichuan University, No. 24 South Section 1, Yihuan Road, Chengdu, China
| | - Siyu Zeng
- School of Logistics, Chengdu University of Information Technology, No. 10, Xingfu Road, Chengdu, China
| | - Xiaozhou He
- Business School, Sichuan University, No. 24 South Section 1, Yihuan Road, Chengdu, China
| | - Jialing Li
- School of Management, Hunan University of Technology and Business, No. 569 Yuelu Avenue, Changsha, China
| | - Guiju Zhu
- School of Management, Hunan University of Technology and Business, No. 569 Yuelu Avenue, Changsha, China
| |
Collapse
|
4
|
Copp T, Dakin T, Nickel B, Albarqouni L, Mannix L, McCaffery KJ, Barratt A, Moynihan R. Interventions to improve media coverage of medical research: a codesigned feasibility and acceptability study with Australian journalists. BMJ Open 2022; 12:e062706. [PMID: 35715183 PMCID: PMC9207948 DOI: 10.1136/bmjopen-2022-062706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Although the media can influence public perceptions and utilisation of healthcare, journalists generally receive no routine training in interpreting and reporting on medical research. Given growing evidence about the problems of medical overuse, the need for quality media reporting has become a greater priority. This study aimed to codesign and assess the feasibility of a multicomponent training intervention for journalists in Australia. DESIGN A small pragmatic feasibility study using a pre- and postdesign. SETTING 90 min online workshop. PARTICIPANTS Eight journalists currently working in Australia, recruited through the study's journalist advisor and existing contacts of the researchers. INTERVENTION The training intervention covered a range of topics, including study designs, conflicts of interest, misleading medical statistics, population screening and overdiagnosis. The intervention also provided tools to help journalists with reporting, including a Tip Sheet and list of expert contacts in health and medicine. Preworkshop and postworkshop questionnaires were administered via Qualtrics. MEASURES Acceptability and feasibility of the intervention, and journalists' knowledge of overdiagnosis and common issues with health stories. Quantitative results were analysed descriptively using SPSS. Qualitative data were thematically analysed. RESULTS All participants completed preworkshop and postworkshop questionnaires, and 6 completed the 6-week follow-up (75% retention). Feasibility findings suggest the intervention is acceptable and relevant to journalists, with participants indicating the workshop increased confidence with reporting on medical research. We observed increases in knowledge preworkshop to postworkshop for all knowledge measures on overdiagnosis and common issues with media coverage of medicine. Analysis of free-text responses identified several areas for improvement, such as including more examples to aid understanding of the counterintuitive topic of overdiagnosis and more time for discussion. CONCLUSIONS Piloting suggested the multicomponent training intervention is acceptable to journalists and provided important feedback and insights to inform a future trial of the intervention's impact on media coverage of medicine.
Collapse
Affiliation(s)
- Tessa Copp
- Wiser Healthcare, Faculty of Medicine and Health, Sydney School of Public health, The University of Sydney, Sydney, New South Wales, Australia
| | - Thomas Dakin
- Wiser Healthcare, Faculty of Medicine and Health, Sydney School of Public health, The University of Sydney, Sydney, New South Wales, Australia
| | - Brooke Nickel
- Wiser Healthcare, Faculty of Medicine and Health, Sydney School of Public health, The University of Sydney, Sydney, New South Wales, Australia
| | - Loai Albarqouni
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | | | - Kirsten J McCaffery
- Wiser Healthcare, Faculty of Medicine and Health, Sydney School of Public health, The University of Sydney, Sydney, New South Wales, Australia
| | - Alexandra Barratt
- Wiser Healthcare, Faculty of Medicine and Health, Sydney School of Public health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ray Moynihan
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| |
Collapse
|
5
|
Thériault G, Breault P, Dickinson JA, Grad R, Bell NR, Singh H, Szafran O. Preventive health care and the media. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2020; 66:811-816. [PMID: 33208420 PMCID: PMC8302440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Guylène Thériault
- Academic Lead for the Physicianship Component and the Director of Pedagogy at the Outaouais Medical Campus of McGill University's Faculty of Medicine in Gatineau, Que.
| | - Pascale Breault
- Clinical Lecturer in the Department of Family Medicine at Laval University in Quebec city, Que
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology of CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
| |
Collapse
|
6
|
Thériault G, Breault P, Dickinson JA, Grad R, Bell NR, Singh H, Szafran O. [Not Available]. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2020; 66:e287-e292. [PMID: 33208439 PMCID: PMC8302437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Guylène Thériault
- Directrice du volet Rôle du médecin et directrice de la Pédagogie au Campus médical de l'Outaouais de la Faculté de médecine de l'Université McGill (Gatineau, Québec).
| | - Pascale Breault
- Chargée de cours cliniques au Département de médecine familiale de l'Université Laval à Québec (Québec)
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire à l'Université de Calgary (Alberta)
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie de CancerCare Manitoba
| | - Olga Szafran
- Directrice associée de recherche au Département de médecine familiale de l'Université de l'Alberta
| |
Collapse
|